Shin-Yuan Chen a, b, c, Sheng-Tzung Tsai a, b, c
aDepartment of Neurosurgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
bDivision of Functional Neuroscience, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
cDepartment of Medicine, Tzu Chi University, Hualien, Taiwan
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder and manifests as bradykinesia, rigidity, resting tremor and posture instability. Although the disease symptomatology can be well controlled by levodopa, related medications and deep brain stimulation, the etiology of PD remains obscure. The epidemiological features have been discussed in depth in the literature, but the methodologies used to approach the issues have varied greatly, and the results cover a wide range of factors and are generally inconclusive. The crude prevalence rate of PD has been reported to range from 15 per 100,000 to 12,500 per 100,000, and the incidence of PD from 15 per 100,000 to 328 per 100,000, with the disease being less common in Asian countries. Risk factor studies have pinpointed cigarette smoking, coffee/tea consumption and alcohol drinking as being mostly related to a lower risk of PD. The relationship between a higher risk of PD and drinking well-water and being exposed to herbicides/pesticides is controversial. Systemic diseases including gout, hyperlipidemia and hypertension may be related to a reduced risk of PD. A family history of PD, tremor, depression and head injury are related to a higher risk of PD. Genetic studies of the glucocerebrosidase, parkin and LRRK2 genes have contributed to our understanding of familial PD but not of sporadic PD. The health-related quality of life of PD patients is related not only to their motor disability, but also to their non-motor symptoms of depression, sleep disturbance, bladder and sexual dysfunction. The economic burden of PD is enormous, and the annual cost of medical service per PD patient can reach €13,804 (NT$599,547).
Keywords
Comorbidity; Economic burden; Epidemiology; Parkinson's disease; Quality of life; Risk factor; Systemic disease
